| Entity Name: | BEACHES BEHAVIORAL MEDICINE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
BEACHES BEHAVIORAL MEDICINE, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 21 May 2014 (11 years ago) |
| Document Number: | P14000045677 |
| FEI/EIN Number |
47-1026373
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 230 Canal Blvd Suite 2, Ponte Vedra Beach, FL, 32082, US |
| Mail Address: | 230 Canal Blvd Suite 2, Ponte Vedra Beach, FL, 32082, US |
| ZIP code: | 32082 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417309832 | 2016-07-09 | 2023-01-12 | PO BOX 1557, PONTE VEDRA BEACH, FL, 320041557, US | 1351 13TH AVE S STE 120, JACKSONVILLE BEACH, FL, 322503237, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 904-280-6701 |
| Fax | 9042806702 |
Authorized person
| Name | DR. JUSTIN KUHNS SPOONER |
| Role | PRESIDENT |
| Phone | 9042806701 |
Taxonomy
| Taxonomy Code | 207QA0401X - Addiction Medicine (Family Medicine) Physician |
| License Number | ME115625 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2083A0300X - Addiction Medicine (Preventive Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 2084A0401X - Addiction Medicine (Psychiatry & Neurology) Physician |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 2084P0804X - Child & Adolescent Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 2084P2900X - Pain Medicine (Psychiatry & Neurology) Physician |
| Is Primary | No |
| Taxonomy Code | 208VP0000X - Pain Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 00863244100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Spooner Justin KM.D. | President | 230 Canal Blvd Suite 2, Ponte Vedra Beach, FL, 32082 |
| DURANT SCHOEPPEL & DECUNTO PA | Agent | 6550 ST AUGUSTINE ROAD SUITE 105, JACKSONVILLE, FL, 32204 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000059684 | BEACHES BEHAVIORAL MEDICINE INC | ACTIVE | 2023-05-11 | 2028-12-31 | - | 230 CANAL BLVD SUITE 2, PONTE VEDRA BEACH, FL, 32082 |
| G21000028049 | BEACHES SPINE AND PAIN | ACTIVE | 2021-02-27 | 2026-12-31 | - | 230 CANAL BLVD, SUITE 2, PONTE VEDRA BEACH, FL, 32082 |
| G21000028050 | BEACHES BEHAVIORAL MEDICINE | ACTIVE | 2021-02-27 | 2026-12-31 | - | 1351 13TH AVENUE SOUTH SUITE 120, JACKSONVILLE BEACH, FL, 32250 |
| G19000013718 | BEACHES SPECIALTY GROUP PA | EXPIRED | 2019-01-25 | 2024-12-31 | - | 230 CANAL BLVD, SUITE 2, PONTE VEDRA BEACH, FL, 32082 |
| G18000062210 | JAX PRIMARY CARE AND PAIN MANAGEMENT | EXPIRED | 2018-05-24 | 2023-12-31 | - | 2550 PARK STREET, JACKSONVILLE, FL, 32204 |
| G16000045172 | BEACHES LASER SPINE AND PAIN MEDICINE | EXPIRED | 2016-05-04 | 2021-12-31 | - | 1411 SOUTH 14TH ST SUITE A, FERNANDINA BEACH, FL, 32034 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-17 | 230 Canal Blvd Suite 2, Ponte Vedra Beach, FL 32082 | - |
| CHANGE OF MAILING ADDRESS | 2023-02-17 | 230 Canal Blvd Suite 2, Ponte Vedra Beach, FL 32082 | - |
| REGISTERED AGENT NAME CHANGED | 2021-03-08 | DURANT SCHOEPPEL & DECUNTO PA | - |
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-08 | 6550 ST AUGUSTINE ROAD SUITE 105, JACKSONVILLE, FL 32204 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-12 |
| ANNUAL REPORT | 2023-04-18 |
| ANNUAL REPORT | 2022-07-20 |
| ANNUAL REPORT | 2021-04-05 |
| Reg. Agent Change | 2021-03-08 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-06-28 |
| ANNUAL REPORT | 2017-03-19 |
| ANNUAL REPORT | 2016-03-26 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 7148847204 | 2020-04-28 | 0491 | PPP | 2550 Park St, JACKSONVILLE, FL, 32204-4518 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Apr 2025
Sources: Florida Department of State
